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From Burnsville, Minnesota, USA:

I'm young (17), thin (5 feet 4 inches tall and 100 pounds), have no history of diabetes in the family, have celiac disease and antibodies for thyroid disease (I don't have it yet but my mom has it), and my doctors have been debating over what type of diabetes I have for over a year now. On the one hand, I'm a "classic typeá1" according to my doctor, but on the other hand, I don't have antibodies for type 1 diabetes, and more importantly, I have a very high C-peptide level, which would indicate typeá2.

At first they thought I was just in a honeymoon, but that wouldn't explain the excessively high C-peptide level. What are your thoughts on this? They are having a hard time trying to figure out how to treat this and my hemoglobin A1c have jumped from 5.9 to 8.8%.


I think that you have to accept that we are still a long way from having molecular definitions for all the many forms of diabetes. In your own case, with positive thyroid antibodies and with celiac disease (that I assume has been confirmed by a positive anti-transglutaminase antibody test), it is hard not to believe that your diabetes is autoimmune based too, even though in theory it might have a quite different etiology.

A clue to this possibility may be gotten by asking for some details about exactly what antibody tests were done. If, for example, this was only a simple immunofluorescent islet cell antibody test, the result might have been a false negative. Likewise if only either or both an anti-GAD and anti insulin antibodies were done and were negative, then anti ICA 512 or anti-phogrin antibodies could still have been positive. In this concept, the C-peptide level could be explained as residual insulin production in a situation where the autoantibody has not yet been defined.

From this, you will gather that you may have to wait a few years for a really precise diagnosis. However, in the meantime, the plans for maintaining good control are really independent of this information.


Original posting 26 Jun 2001
Posted to Diagnosis and Symptoms


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Last Updated: Tuesday April 06, 2010 15:09:22
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